Encopresis and chronic constipation – the facts

Encopresis may sound like a complicated condition, but it’s pretty easy to understand once you’ve got the basics.

It’s a condition in toddlers and young children where they soil their underwear because of chronic constipation.

The facts

Encopresis occurs when your child is unable to pass bowel movements for a prolonged period of time (whether that is the child holding it in or being constipated for another reason), and so the poo gets impacted (backed up) inside the colon. After it has been impacted for a while, the bowel muscles start to stretch and the nerves that tell the child when to go to the toilet are affected.

With muscles stretched and nerves not working properly, small amounts of runnier poo can escape past the compacted poo without your child knowing until it is in their underwear – they usually can’t feel it at all and may not know until it is pointed out to them. This condition affects around 1-2% of kids under 10.

The main thing to remember is that this is not a decision on your child’s part or a behavioural issue of any kind – so punishment is not an adequate measure to stop it happening. A doctor’s visit and positive encouragement from you is what they need.

Symptoms

Your child may show any or all of these symptoms:

Leakage of poo (whether runny or hard) in your child’s underwear – sometimes if it is a large amount, you can mistake it for diarrhoea

Constipation

Fear of passing bowel movements

Abdominal pain

A long time between bowel movements (even as long as a week)

Repeated urinary tract infections (UTIs)

Treatment

The doctor will diagnose based on physical exams and/or x-rays. Once they have decided your child does have encopresis, the following treatment plan would be put in place.

Firstly, your child’s bowel needs to be emptied as soon as possible. There are a few methods your doctor can prescribe including:

Stool softeners, such as lactulose

Colon lubricants, such as mineral oil

Rectal suppositories

Enemas

More oral fluids

Your child may need subsequent x-rays just to make sure there bowel is fully emptied. Once their bowel is all clear, you need to keep them passing bowel movements regularly. This can be done by ensuring your child’s diet is high in fibre, they are drinking lots of liquids, and possibly using stool softeners more long-term to make sure everything keeps moving healthily.

Occasionally, there could be a psychological problem as to why your child was holding in their poo in the first place, so this may be a port of call if the condition doesn’t resolve itself after the above treatment.

If you are worried that your child may have encopresis, do not hesitate to see your doctor, as earlier detection and treatment is always best for you child, and for your own stress levels. Remember not to get angry with your child – it is not their fault.

Note: This post is not intended to be a replacement for medical advice. If you have any questions or concerns about your child’s health, please see a medical professional.

Have your say:
Have any of your kids experienced this?
What do YOU think? Let us know.

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Yes, our at-the-time 4-year-old daughter got this. It was horrible. We didn’t even know she had been constipated. She had mentioned once that it hurt to go to the toilet. Maybe a second time, a few weeks later, but nothing frequent.

We actually eat fairly healthy, but we had had a month-long run of long, busy schedules so were eating a little more fast food than usual and not being as strict on the “bad” food that our DD was getting a little more often than usual (normally it was a treat, at this point it had become a little more than that due to our exhaustion).

When she started to ‘leak’ she was as surprised as us to see the poo in her pants. When I actually saw it happen (in the bath) and saw she had no idea until I showed it to her – I made a Dr appt for the next day. They sent her straight for an X-Ray and then told us it was something called encopresis – apparently more common in 4 yo boys then girls!

The worst part was, we were about to go overseas in a matter of days. The best course of action was decided – to give our DD an enema. I never, ever want to have to hold a 4 yo girl (or anyone) down for one of those again. 🙁
We also had to give her some medicine for the next two weeks while we were overseas. The poor child also had to sit and eat broccoli or other fruits and veges before being allowed to eat what her cousins were eating for tea – whether it was pizza or other tempting foods for kids. We were surprised that she didn’t even complain about having to do this – I think the enema was a wake up call for all of us 🙁

Since then, we have been very careful (my DH would probably say I bordered on being a tad paranoid) about ensuring our DD has a balanced diet with lots of fibre. We’re not perfect, but if we find she is a little constipated it’s high fibre foods again for her for the next week. This is NOT a nice condition to have to “fix”.

TPS Health Physiotherapy and Pilates has three clinics located at Morningside, Redlands and Lutwyche. We offer pre and post natal services as well as physiotherapy and Pilates. All clinics offer child minding services so bubs are always welcome!